Hope in Counselling and Psychotherapy

SAGE Publications Ltd, Denis O′Hara

• Publisher: SAGE Publications Ltd
• Year: 2013
• Print ISBN: 9781446201701, 9781446201695
• eBook ISBN: 9781446283103
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

?This book represents a major contribution to the literature of several professions. Presenting an account both rich and broad, the author provides a summary and overview of ?hope? from philosophical, nursing, psychotherapeutic and research perspectives.?

Ian Townsend, Associate Lecturer in Counselling, Blackburn College

Engendering ?hope? is at the heart of counselling and psychotherapy but, until now, little attempt has been made to actually explain howand why it may be fostered. Understanding the central role of hope in healing and personal growth is an essential element of counsellor training and practice. It forms the basis of the therapeutic relationship and is integral to the very aims and motivation of counselling.

Keeping theory firmly grounded in real-life practice, this book explores:

-The nature of hope and how it is conceptualised from different theoretical perspectives.

-The common psychotherapeutic practices which engender hope and how they translate into effective practice

-The role of the counsellor in the process

-How to manage expectations and work effectively with clients suffering with severe and enduring psychological challenges

-Hope measures, and how to be a research-informed practitioner.

Packed full of case examples, practical exercise and points for reflection, this book is essential reading for any training or practising healthcare professional looking to understand the role of hope in the process of change.

Section 1

Understanding the nature of hope

1

Introducing hope

If we asked an average group of people to brainstorm a list of factors that contributed positively to mental health and well-being, it is likely that they would identify several in common. The list might include: the provision of basic needs like food, clothing, shelter, etc.; care and emotional support from significant others; financial provision through gainful employment; pleasure through leisure pursuits; and a positive mental outlook. People who look to their future with a good measure of positive expectancy are likely to think well of themselves and of their opportunities in life. Such people probably have a number of life goals, generally look forward to their working day, and experience some form of enjoyment in their relationships and life pursuits. Of course, no one is exempt from experiencing challenging life events. Even the most positive individuals will at times experience more difficult emotions like sadness, worry, or despair. Mentally healthy people though seem to have an orientation to life that allows them to be grounded and optimistic even in the most challenging of circumstances.

This view is reflected in the World Health Organization’s (WHO) definition of health as:

a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. (WHO, 2001)

It is important to note that mental health and well-being is understood to be much more than the absence of disease. In fact mental health may exist in the presence of physical illness. A comprehensive understanding of health, especially mental health, focuses on what factors support health and well-being, rather than on factors that cause disease. This view, known as the salutogenic approach to health, claims that health is much more open-ended than in a disease model of health and is dependent on the skills necessary to organise resources in society, the social context, and the inner resources of the self. ‘This framework suggests that what we perceive as being good for ourselves (subjective well-being) also predicts our outcome on objective health parameters. In other words, if we create salutogenic processes where people perceive they are able to live the life they want to live they not only will feel better but also lead better lives’ (WHO, 2005: 51).

It appears that having a positive life orientation is one of the ingredients of a healthy life. If this is so, then we need to understand more precisely what such a personal worldview is, how it functions, and how it can be fostered. In the following chapters, this positive life orientation will be referred to in various ways using such terms as optimistic, sanguine, hopeful, and resilient, to name a few. While these and other related terms will be examined, the primary focus of this book will be on the nature and function of hope. The capacity to hope, it will be argued, is essential for health and well-being. Those without hope are certain to struggle with themselves and their life circumstances. Our examination will highlight the fact that hope is a more complex notion than might generally be thought. It is a word used in everyday speech to refer to relatively mundane thoughts such as ‘I hope it’s not going to rain today’ and also to more profound ideas like ‘There’s no hope for me’. Hope is a word that captures a range of nuanced meanings and therefore requires a thorough scrutiny.

Before we venture too far into the research literature it might serve us well to start with a few definitions of hope. The following definitions are drawn from commentators from different disciplines and provide a breadth of perspective on the nature of hope.

Hope is:

‘a movement or stretching forth of the appetite towards an arduous good.’ (Aquinas, 2006a)

‘a process of anticipation that involves the interaction of thinking, acting, feeling, and relating, and is directed towards a future fulfilment that is personally meaningful.’ (Stephenson, 1991: 1459)

‘a multidimensional life force characterized by a confident yet uncertain expectation of achieving a future good which, to the hoping person, is realistically possible and personally significant.’ (Dufault & Martocchio, 1985: 380)

‘the sum of perceived capabilities to produce routes to desired goals, along with the perceived motivation to use those routes.’ (Snyder, 2000: 8)

A number of key characteristics of hope are represented in these definitions. They suggest that hope involves:

• Appetites/desires

• Anticipation

• Confident expectation

• Life force

• An arduous process

• Realistic possibilities

• Issues of personal significance

• Perceived personal capability

• Goals, pathways/routes, motivation/agency

• An interaction between thinking, acting, feeling, and relating.

As we explore the topic of hope each of these characteristics will be examined in more detail. To develop the definitional aspects of hope a little further we now turn to the dictionary for further clarification.

Hope as a noun

Hope is defined in the Oxford dictionary as both a noun and a verb. As a noun, hope is: a feeling of expectation and desire for a particular thing to happen. Eliott and Olver (2002) noted that when hope was described as a noun it was represented as an entity, and therefore in a sense as existing independently of the individual. In this respect, hope was ‘out there’ and could either be gained or lost. One of the interesting features of hope as a noun is that it is viewed as having an a priori existence. If hope already exists the implication is that it cannot be created but rather only be gathered in lesser or larger amounts. Hence, hope can grow and increase or equally it can diminish and vanish. Another feature of hope as a noun is that it must have an object. There is a hope for or of something happening. This object may be something concrete or something less tangible such as a state of being. In either form, hope has an object of desire.

Hope viewed as a noun tends to orientate the hoper to a modernist view of reality where aspects of reality either exist in principle, as in Platonic forms, or as physical and measurable entities. When hope is conceived of as already existing in the real world in some form or other it carries the notion that it can be gained, given, or discovered. This has both positive and negative aspects. The view that hope might exist in some fashion and that it needs to be procured somehow means that there is a potential positive expectation of either gaining the object of hope or of gaining more of the quality of something desired, for example, affection. On the negative side, the object of hope may be withheld or be unavailable.

Hope: given or taken

Another feature of hope as a noun is that it is often conceived of as being outside of one’s control. This is best illustrated by research on the participation of patients in medical treatment. Eliott and Olver (2002), for example, reported that patients undergoing medical treatment often link hope with cure. Hope then becomes associated with the presence or absence of an objective, empirical fact. When a medical report is good, for example when there are no further cancer cells found after an operation, hope is delivered. Hope in this context is seen as being in the hands of the doctor. If the doctor delivers a positive word, hope is possible; alternatively, a negative report is more likely to lead to a loss of hope. There is a sense here of hope as being able to be either given or taken. When hope exists as an entity outside of the person there is a danger that it is represented as an absolute, with its possibility or impossibility already predestined.

A negative feature of hope seen as being outside of one’s control is that it can lead to inaction. If hope is ‘out there’ then there is nothing I can do about it. All I can do is wait for my fate to be delivered. In psychological terms we might speak of someone with this orientation as lacking self-efficacy (Bandura, 1982). Such persons do not believe that they can effect any change in their circumstances, whether physical or emotional, because it is out of their control. In the medical context this view renders the doctors as having all the power. Only they can make any difference to the individual’s state of being.

Hope understood as something pre-existing has a positive dimension as well. Many people relate to hope as an aspect of spirituality. In monotheistic religions, for example, God is the giver of hope. ‘“I know the plans I have for you”, declares the Lord “… to give you a hope and a future”’ (Jeremiah 29:11, New International Version). God in this scheme is a benevolent, powerful being able to offer and provide hope. Sometimes this offer of hope is seen as the potential attainment of some temporal desire, like health, a relationship, a job, or some physical object. Equally God’s offer of hope may be to gain some eternal state such as heaven or eternal peace. The interesting thing here is that hope is understood as being possible because a power greater than the individual is able to provide it.

Hope discovered

Another response to viewing hope as existing objectively is to actively seek hope. While similar to a view of hope as being received, its focus is potentially more active. This more self-efficacious view sees the person as being on a journey of discovery. If hope is lacking and it exists in principle, then it should be able to be found. Many people enter counselling and psychotherapy with such an assumption. It is as if they have recently lost something they previously possessed and now need to find again. Such people come to therapy to enlist the therapist’s aid in helping them find their elusive hope. Like hope given, hope discovered implies that hope itself has a quantitative characteristic – hope can grow or diminish. Such a view also has a positive and self-empowering aspect, for if hope can grow in quantity then human effort can make a difference. The more I seek that which I am after and the more I rid myself of blockages to its attainment, the more likely it is that I will attain my goal.

Hope as a noun implies that hope has some form of independent existence and in some way is outside the person. It does not, however, have to remain outside for whether hope is given and received or actively sought and discovered, hope can be gained and become the individual’s psychosocial and spiritual possession. The different aspects of hope as a noun are summarised in point form below.

Hope as noun

• Hope is a pre-existing objective entity

It can increase and decrease

• Passive engagement

It can be given or provided

It can be received

• Active engagement

It can be pursued and discovered

It can be possessed

Hope as a verb

Hope as a verb is the act of desiring, of having confidence, of believing or trusting in someone or something (Webster’s Dictionary, 2006). An interesting aspect of hope as a verb is that it introduces a subject. There is someone doing the hoping. Hope as a noun highlights more of the objective nature of hope, while hope as a verb highlights its subjective features. In hope as a verb the actional dimension is personalised, providing more power to the individual to choose the object of hope. In their study on hope and cancer patients, Eliott and Olver (2002) found that patients who referred to hope in its verbal form were less dependent on the doctors’ pronouncements for the maintenance of their hope. While a good report from the doctors was welcomed, it did not necessarily determine the person’s ability to hope as this capacity was already subjectively held. To hope was already an engagement in an active process. To hope meant that there was a belief that something positive and desirable was possible.

Hope used as a verb tends to focus on possibilities; here the future is more open-ended. In contrast, hope used as a noun is more likely to refer to definitive outcomes, a prescribed response. Hope as an action requires some behavioural response from the individual. Hope has to be evidenced in some way and usually involves a level of risk or trust in another or in some possibility. The action, for example, might simply be a choice to contact a friend and arrange a social chat even when one feels unwell and unsociable. It may be the act of risking the possibility of being vulnerable in a close relationship or of ceasing further medical treatment in preference for a short-term improvement in the quality of life. Such expressions of hope involve more than conceptual acknowledgements of desired outcomes, rather, they require some self-empowered action by the hopeful person.

Hope as a verb also involves a sense of motivation, an energy directed to an action. As we will see later in the section on positive psychology and hope, hope involves the capacity for agency, that is, belief in one’s own capacity to effect change in one’s world. When used as a verb, hope implies action. An illustration is helpful here. If Bill were to say, ‘I hope that I get the job I applied for soon’, then he is using the word ‘hope’ as an action; Bill is engaging in the act of hoping. But what is this action? One important aspect of hope is that it is intentional. It is directed at the attainment of some desired object or state of being. The etymological meaning ...

Table of contents

• Cover Page
• Halftitle
• Advertisement
• Title
• Copyright
• Dedication
• Contents
• About the Author
• Preface
• Acknowledgements
• Section 1  Understanding the nature of hope
• Section 2  The practice of hope
• Section 3  The research-informed practitioner
• Appendix
• References
• Index